Definitions HPM 101 Flashcards
Health
A state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.
Health system
delivers quality services to all people when and where they need them. Consists of all organizations, people, and actions whose primary intent to promote, restore, and maintain health
Health Care
refers to medical services, health system and health policy involves all areas including public health.
Social epidemiology
studies the distribution of a disease within a population according to social factors, such as use of drugs or heterosexual behavior or social class, rather than biological factors such as high blood pressure.
Prevalence
refers to the total number of cases within a specified population at a specified time-both those newly diagnosed and and those diagnosed in previous years but living with the condition under study.
Incidence
refers to the number of new occurrences of an event (disease, birth deaths, etc.) within a specific population during a specified period.
Life expectancy
the average period a person may live. Reflects the overall mortality level of a population. It summarizes the mortality pattern that prevails across all age groups-children and adolescents, adults, and the elderly.
Maternal mortality
the annual number of female deaths from any cause related to or aggravated by pregnancy or its management during pregnancy and childbirth.
Infant mortality
is the death of an infant before his or her first birthday. Is the number of infant deaths for every 1,000 live births.
Morbidity
departure from a state of physical or psychological well-being, resulting from disease, injury, or sickness. Disability may be limited to a few days during acute illness with measles or years of disability with blindness.
Mortality
the frequency or rate of death in each population.
Upstream factors
Are closer to the fundamental cause and often farther from the observed health outcome. (Examples- income, accumulated wealth, educational attainment, and experiences based on racial or ethnic identification)
Midstream
features of neighborhoods and work environments.
Downstream
factors are closer to the causal chains such as unhealthy diets, lack of exercise, and smoking (proximate)
Social class- Social economic status (SES):
Social class refers to individuals’ education, income, and occupational status or prestige. Where people are in a social hierarchy affects the conditions in which they grow, learn, live, work and age, their vulnerability to ill health and the consequences of ill inequalities.
Building Blocks
Leadership/governance, health care financing, health workforce, medical products and technologies, information and research, service delivery to achieve goals such as improved health (level and equity), responsiveness, financial protection, improved efficiency.
Epidemiological transformation
Antibiotics and vaccines along with improved nutrition, general health and social welfare led to dramatic reductions in infectious disease morbidity and mortality.
Cultural competency
acknowledges and incorporates importance of culture, vigilance toward the dynamics that result from cultural differences, adaptations to meet culturally unique needs. A culturally competent system is built on awareness of the integration and interaction of health beliefs and behaviors, disease prevalence and incidence for different patient beliefs. (There are some problems with cultural competence)
Cultural Humility
refers to an orientation towards caring for one’s patients that is based on: self-reflexivity and assessment, appreciation of patents’ expertise on the social and cultural context of their lives, openness to establishing power-balanced relationships with patients, and a lifelong dedication to learning. Meaning that one does not know and is willing to learn from patients about their experiences, while being aware of one’s own embeddedness in culture(s).
Primary prevention
the goal is to protect healthy people from developing a disease or experiencing an injury in the first place.
Secondary prevention
These interventions happen after an illness with serious risk factors has already been diagnosed. The goal is to halt or slow the progress of disease (if possible) in its earliest stages; in the case of injury, goals include limiting long-term disability and preventing re-injury. (Examples: low dose of aspirin to prevent heart attack, screenings, regular exams)
Tertiary prevention:
Focuses on helping people manage complicated, long term health problems such as diabetes, heart disease, cancer and chronic musculoskeletal pain. The goals included preventing further physical deterioration and maximizing quality of life. (Example: cardiac or stroke rehab, management programs, patient support groups)
Community rating
A health plan sets the same premium rate for everyone in each geographical area. The insurer thus ignores any differences in expected costs among insured groups or people (previous illness, existence of chronic conditions, risky lifestyles etc.) It achieves redistribution of health care more in accordance with human need from healthy to sick and from rich to poor.
Experience rating
People pay different premiums based on differences in their demographics, past health care utilization, medical status and other factors. This type of ‘experience or actuarial rating’ is used to minimize risk associated with policyholders who have high-risk related conditions.
Redlining
The refusal of coverage to certain individuals or groups on the basis of geographical location, belonging to certain business groups that were considered as high-risk or on the basis of history or excessive claims.
Premium
Payments by the insured on a monthly or annual basis to cover the specific set of losses indicated in the insurance policy.
Deductible
The amount you must cover for medical expenses before your insurance policy starts paying. Deductibles are usually made on an annual basis.
Out-of-pocket maximum
A cap or limit on the amount of money you have to pay for covered health care services in a plan year.
Co-payment
a contribution made by the insured person toward the cost of medical treatment or other services.
Co-insurance
the percentage under an insurance plan that the insured person pays toward a covered expense or service.
Universal health coverage
a system where everybody is covered.
Equity
the idea that everyone should have a fair and just chance to achieve their best health, regardless of factors that can affect health outcomes.
Gender
Socially created and learned distinctions that specify the ideal physical, behavioral mental and emotional traits characteristics of males and females.
Racial disparity
the increased presence and severity of certain diseases, poorer health outcomes and greater difficulty in obtaining healthcare services for certain races and ethnicities.
Social gradient
People who are less advantages in terms of socioeconomic position have worse health (and shorter lives) than those who are more advantaged.
Asymmetry of information
need to rely on physicians for the treatment decisions. Healthcare providers KNOW more than the patients about health problems. They have education and experience, i.e. expertise- to make treatment decisions.
Employment-based insurance:
individuals receive insurance through their full-time jobs, this is private insurance. This concept evolved rapidly in the three decades after World War II. Employment based insurance allowed health insurance to be tax exempt if sponsored by employers. The employers offered health insurance as a fringe benefit to attract good workers. Substantial efficiency advantages of group over individual insurance.
